Liu Shixuan, Liu Lin, Lu Xinyue, Yao Tingfeng
Department of Rehabilitation, School of Sport Health, Nanjing Sport Institute, Nanjing, People's Republic of China.
J Pain Res. 2024 Mar 27;17:1299-1311. doi: 10.2147/JPR.S449750. eCollection 2024.
Myofascial trigger points (MTrPs) are the main cause of myofascial pain syndrome (MPS), and patients with MPS also have symptoms of sympathetic abnormalities. Consequently, this study aimed to investigate the potential relationship between MTrPs and sympathetic nerves.
Twenty-four seven-week-old male rats were randomly divided into four groups (six rats every group). Groups I and II were kept in normal condition (n=12), and groups III and IV underwent MTrPs modelling (n=12). After successful MTrPs modelling, differences in sympathetic outcomes between the MTrPs groups (III and IV) and non-MTrPs groups (I and II) were observed. Sympathetic blockade was then applied to groups III and I (n=12). Data were collected on peak inversion spontaneous potentials (PISPs) and the H-reflex-evoked electromyography during spontaneous discharge at the MTrPs before and after sympathetic blockade.
Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate were significantly higher in the MTrPs group than in the non-MTrPs group (P<0.05). Compared with group I, group III had the PISPs potential lower wave amplitude, shorter duration and amplitude-to-duration ratio, and lower H latency and latency difference H-M (P<0.05). Compared with group IV, group III had the PISPs potential lower wave amplitude, duration, amplitude-to-duration ratio, M-wave latency, H maximum wave amplitude, and maximal wave amplitude ratio H/M (P<0.05). The changes before and after sympathetic blockade in the MTrPs group were significant, and the amplitude, duration, and amplitude-to-duration ratio of the PISPs potentials were lower after the blockade (P<0.05).
MTrPs and sympathetic nerves interact with each other forming a specific relationship. MTrPs sensitize sympathetic nerves, and sympathetic nerve abnormalities affect local muscle myoelectric hyperactivity, leading to MTrPs. This finding is instructive for the clinical management of sympathetic disorders.
肌筋膜触发点(MTrPs)是肌筋膜疼痛综合征(MPS)的主要病因,MPS患者还伴有交感神经功能异常症状。因此,本研究旨在探讨MTrPs与交感神经之间的潜在关系。
将24只7周龄雄性大鼠随机分为四组(每组6只)。第一组和第二组处于正常状态(n = 12),第三组和第四组进行MTrPs建模(n = 12)。成功建立MTrPs模型后,观察MTrPs组(第三组和第四组)与非MTrPs组(第一组和第二组)之间交感神经结果的差异。然后对第三组和第一组(n = 12)进行交感神经阻滞。收集交感神经阻滞前后MTrPs处自发放电时的峰值反向自发电位(PISPs)和H反射诱发肌电图数据。
MTrPs组的收缩压、舒张压、平均动脉压和心率显著高于非MTrPs组(P<0.05)。与第一组相比,第三组的PISPs电位波幅较低、持续时间较短、波幅与持续时间比值较低,H潜伏期和潜伏期差H-M较低(P<0.05)。与第四组相比,第三组的PISPs电位波幅、持续时间、波幅与持续时间比值、M波潜伏期、H最大波幅和最大波幅比值H/M较低(P<0.05)。MTrPs组交感神经阻滞后的变化显著,阻滞后PISPs电位的波幅、持续时间和波幅与持续时间比值较低(P<0.05)。
MTrPs与交感神经相互作用,形成特定关系。MTrPs使交感神经敏感化,交感神经异常影响局部肌肉肌电活动亢进,导致MTrPs。这一发现对交感神经紊乱的临床治疗具有指导意义。